Allan B D, Baer R M, Heyworth P, Duguid I G, Dart J K
Moorfields Eye Hospital, London.
Br J Ophthalmol. 1997 Jul;81(7):548-50. doi: 10.1136/bjo.81.7.548.
To determine the clinical intervention rate during routine review after uncomplicated phacoemulsification.
A review of case notes in 651 consecutive cases of uncomplicated phacoemulsification from 1994 (< or = 5.5 mm self sealing wound) was performed. The intervention rate at scheduled routine review visits and at unscheduled visits to the eye casualty service in the first 120 postoperative days was recorded. Interventions were defined as departures from predetermined postoperative care protocols.
Clinical interventions were reported in 2.8% (95% confidence interval 1.5 to 4.1%) of (n = 1652) routine follow up visits. Many of these interventions were avoidable or trivial; 90% of patients had no postoperative intervention at any visit. 7.3% of patients made unscheduled visits to the emergency service. The intervention rate in this group was 50% (35.9 to 64.1%).
The intervention rate in routine clinical review after uncomplicated modern cataract surgery is low. Alternatives to conventional postoperative review, including shared care with non-ophthalmologists and improved perioperative patient education with an open channel for self referral, should be evaluated.
确定单纯性白内障超声乳化术后常规复查期间的临床干预率。
对1994年(≤5.5mm自闭式切口)连续651例单纯性白内障超声乳化病例的病历进行回顾。记录术后前120天预定常规复查访视及非预定眼科急诊访视时的干预率。干预定义为偏离预定术后护理方案。
在1652次(n = 1652)常规随访访视中,2.8%(95%置信区间1.5%至4.1%)报告有临床干预。其中许多干预是可避免的或轻微的;90%的患者在任何一次访视中均无术后干预。7.3%的患者进行了非预定急诊访视。该组的干预率为50%(35.9%至64.1%)。
单纯性现代白内障手术后常规临床复查的干预率较低。应评估传统术后复查的替代方案,包括与非眼科医生共同护理以及通过开放的自我转诊渠道改善围手术期患者教育。